Provider Demographics
NPI:1063655900
Name:CHITO, SANDRA (MSW- LICSW)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:CHITO
Suffix:
Gender:F
Credentials:MSW- LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 FABIEN ST
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-6277
Mailing Address - Country:US
Mailing Address - Phone:401-309-3437
Mailing Address - Fax:401-775-1507
Practice Address - Street 1:8O FABIAN STREET
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-4402
Practice Address - Country:US
Practice Address - Phone:401-309-3437
Practice Address - Fax:401-775-1507
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-08
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW021381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical